LeMerise 1

Lisette LeMerise

Dr. Tim Moran

PS 1010 Section 516

21 March 2018

In today’s society, stress and anxiety have become major problems that are not dealt with

adequately. The United States’ federal and state governments have begun to focus on the

problem, but with limited scope and impact. Instead, local government policies, such as

ThriveNYC developed by New York City’s mayor and “spearheaded by First Lady Chirlane

McCray” (Anzilotti), have developed more effective means of solving stress and anxiety, mainly

since they can focus on the needs of a specific culture of people. Therefore, the policy of

ThriveNYC can be considered one that wins and works due to its combination of mechanisms

into a roadmap for success, including increasing funding, working with the civic sphere, helping

the young, providing greater access to help, and lowering the stigma against mental illness.

From the 1900s to the 2000s, the major killers in the United States have changed

drastically. No longer are they major diseases like Tuberculosis or Pneumonia. Rather, they have

shifted to being life-style related and including killers like heart disease, cancer, and stroke,

which are highly correlated with stress and anxiety (McDaniel). In fact, today, “nearly 1 in 5

university students are affected with anxiety or depression” (Rosenberg), with 73.1% of college

counselors finding an increase in the severity of student mental health concerns (Reetz et al. 65).

This is partly due to increased medical knowledge and understanding of diseases to solve them

medically. However, this also indicates that people’s lives have generally become safer, with less

of a need to use the body’s fight-or-flight response for its intended purpose of self-preservation
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from a bear, for example. Instead, with the increase in social media and the development of a

fast-paced society, the fight-or-flight response is used inappropriately, activating the sympathetic

nervous system when worrying about a test, making a phone call, posting on social media

(Rosenberg), or living and thinking about events that would not normally kill someone. With

many small, daily stressors, chronic stress often develops, which can lead to more serious health

concerns like anxiety: “[S]tress and anxiety are separate ideas, with stress being the day to day

pressures one feels, and anxiety being serious disorders like “generalized anxiety disorder

(GAD), panic disorder, phobias, social anxiety disorder, obsessive-compulsive disorder (OCD)

and post-traumatic stress disorder (PTSD)” (World Health Organization 7)” (LeMerise 1).

Additionally, this problem is exacerbated since it starts young: “[C]hildren in schools

[with conduct disorder], for example… are punished when often the root of the problem could be

trauma, domestic problems or a mental illness that has not been properly diagnosed” (Canady 1).

This permanently alters their perception of the world and trains children to be more stressed as

adults since the brain develops in response to experience and what it is more likely to do. Thus,

the stress response becomes more efficient and likely (Kott). Treatment options are also limited,

particularly for children and teens (Thompson 1), and especially in major cities like Detroit

where stress is more prominent (LeMerise 1). This issue then continues throughout one’s life,

especially in the United States where a stigma against those with mental illnesses persists

(Wallace 5), and high rates of problematic coping mechanisms occur such as substance abuse

(Rosenberg).

These compounding factors matter since stress and anxiety are persistent and lead to

higher death rates and medical issues. Chronic stress leads to shortened telomeres which

degrades DNA. The fight-or-flight response also produces high cortisol levels, and at the chronic
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level, leads to clogged arteries and increases the probability of sickness or death (Marmot et al.).

This leads to less efficient workers and societies. Clearly, the problem of stress and anxiety

extends beyond the personal level. This has become a societal dilemma that continues to worsen,

indicating the government’s newfound desire to find a workable solution.

However, most efforts already taken have been limited, notably at levels of government

higher than the local or state levels. For example, research has been conducted in various school

districts at the local level to discover causes of stress and anxiety. One study on a school in

Pennsylvania found that many of its students are stressed regularly, and that teachers lack the

training to correctly manage student stress (Figueroa 55). Instead, they often misinterpret

student actions, making the situation worse by punishing students or ignoring a chance to help

and prevent further issues, allowing student anxiety to persist: [T]he fight-or-flight scenario,

which is the most common emotional and behavioral display of anxious students, is often being

misunderstood as defiant and uncooperative behavior for the anxious student” (Figueroa 54).

At higher levels of government, such as the federal level, officials and policies are limited

in their capacity to address the issue. Though the federal government has greater access to

resources like money, it has a larger scope of people to address. This is problematic since stress

and anxiety tend to vary per individual, while the federal government addresses an entire nation

of citizens as if they were one. Therefore, most efforts taken by the federal government address

issues affecting a multitude of people. Efforts range from preventing discrimination in the

workplace for those with mental illnesses, which the federal government has dealt with before

for other demographics, and preventing or eliminating substance abuse (LeMerise 1). To the

federal government, stress and anxiety are considered personal issues rather than nationwide

emergencies, and are less likely to be addressed at that level of government.

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Consequently, new policies have started to develop that focus on smaller groups of

people and cater to the personal level. One such solution is ThriveNYC, a policy developed to

tackle mental illnesses in New York City. NYC is fast-paced, modern, and full of people

working for cutthroat businesses and corporations where they have to compete and compare

themselves to others, causing anxiety levels to run high (Marmot et al.). Furthermore, NYC is

filled with schools of young children, and is a popular destination for young adults to visit, go to

university, or develop their careers which builds on their stress and anxiety. NYC is the perfect

location to initiate a policy of pilot programs to test mental health aid. After all, ThriveNYC is an

outlined roadmap of how to tackle mental illness, and “[this] mental health reform effort could

become a national model” (Canady 1). The “holistic system outlines 54 targeted initiatives, 23 of

them new, to support the mental well-being of New Yorkers” (Canady 1), and has six main

foundations: Change the Culture, Act Early, Close Treatment Gaps, Partner with Communities,

Use Better Data, and Strengthen the Government’s Ability to Lead (The City of New York),

illustrating its mechanisms for success.

ThriveNYC’s first mechanism is to increase funding toward initiatives aiding those with

mental illnesses. Mayor Bill de Blasio started the plan with an $850 million budget (LaMantia),

and has since then decided to “increase the city’s overall behavioral health budget by 25%, to

$1.2 billion in fiscal 2019 from $973 million in 2015” (Lewis). Additionally, the city’s goal is to

deal less with the federal government in regard to spending so the city can behave more

independently and make its own decisions based on its specific culture of people: “Before

ThriveNYC launched in November 2015, about 75% of funding for the city’s behavioral health

services came from the state and federal governments. About 78% of the funding for

ThriveNYC initiative will come from the city between fiscal 2016 and fiscal 2019” (Lewis).
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ThriveNYC’s second mechanism toward success is to work with the civic sphere and its

nonprofit organizations to provide more impactful initiatives like mental health first aid. This

grants the city more resources from outside sources to reach their goal of training “one-quarter of

a million New Yorkers in Mental Health First Aid… [and] to reach out to family, friends and co-

workers suffering” (Canady 1). This presents the city with more people to provide training, along

with greater efficiency to train more individuals at once. It also gives the city the ability to

develop other programs, such as one for peer-specialist training which has already yielded 300

graduates. Additionally, this mechanism is effective because a single training can provide an

individual with enough knowledge to instantly have a better relationship with stress and receive

less of its negative effects (McGonigal). Having more trained individuals presents the city with

more outlets to use for coping, and the “most important thing [for people] suffering with mental

illness is to have someone they trust to talk to.” (Canady 1).

To employ a preventative approach, ThriveNYC’s third mechanism is to help the young,

especially through the educational system. This is a critical approach, since “[h]alf of all mental

health conditions and substance use disorders start before the age of 14” (McCray, Buery, &

Bassett 3). Specifically, ThriveNYC has started the ‘“Talk to Your Baby” campaign, which

“urges caretakers to talk, read and sing to their babies, [and] will promote more emotional well-

being for children in low-income areas” (Eide). The program has also introduced a School

Mental Health Consultation program and The Social-Emotional Learning initiative currently

affecting 8,803 EarlyLearn students and developing an Early Childhood Mental Heath Network

serving 4,805 children, teachers, caregivers, and families (McCray, Buery, & Bassett 3).

Similarly, ThriveNYC’s fourth mechanism is to provide access to help for those with

limited access, whether it be for children or adults. The Assertive Community Treatment
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program has developed to lower treatment costs and provide an alternative form of care for

mental health (Anzilotti), along with a new initiative to increase “access to mental health care for

poor and minority workers” (Eide), otherwise known as “vulnerable” New Yorkers. This allows

the local government to effectively address its specific people by catering their methods to them.

NYC knows it has high rates of police encountering mentally ill individuals and behaving

inappropriately, so they have increased funding for Crisis Intervention Team training to “instruct

cops on how to deescalate encounters” (Eide). They also cater aid by making programs specific

to the institute, such as senior centers, homeless shelters, and family justice centers which all

have different needs. They even cater to the general New Yorker by establishing the NYC Well

Hotline, making this an effective approach to addressing the needs of all types of citizens.

Finally, the policy’s fifth mechanism is to work with the personal sphere to lower the

stigma surrounding mental illness. This should lower resistance to the presented solutions for

stress, anxiety, and other mental illnesses. For example, the city funded $15 million to the

“Today I Thrive” ads “on television, online, social media, the subways, and bus shelters” (Eide).

Additionally, the city is surpassing its goal for mental health first aid (McCray, Buery, & Bassett

2), which reduces the stigma by informing more people about the problem. This method is highly

effective, considering it works with the nation’s values to gain public support for the policy.

However, the policy itself still encounters structural barriers preventing it from meeting

its potential. It might be helping the wrong problem, meaning it is working within the wrong

societal structure. In other words, critics like Eide claim the policy has difficulty identifying the

root causes, and that mental illness should not incorporate every person facing adversity. Rather,

the policy should narrow its scope and work in a smaller structure so as not to spread itself too

thin and create policies that prevent helping “truly psychotic individuals” (Eide). This policy also
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requires increasing government control which many Americans do not agree with, especially

those believing in the Protestant work ethic and classical liberalism (Garfinkel et al. 1). This is

especially true since the structure of the U.S. society has already imbedded the stigma against

mental illness within it, as indicated by common stereotypes like “the belief that they are

responsible for their own illness and therefore blameworthy and… dangerous” (Wallace 5). Plus,

some find the stigma necessary: “This is what causes the public aversion… People will never

tolerate bizarre, violent, psychotic behavior. Never have. Never will.” (Steager).

The other issue hindering this policy is that it requires working with other societal

spheres and levels of government, as well as its expectation to apply easily to other governments.

Working in too many spheres and levels can make it difficult to coordinate toward a common

goal, though the city has formed the Cities Thrive Conference and the Mental Health Council for

this purpose (McCray, Buery, & Bassett 12). Plus, “not every city has an $850 million budget

(Anzilotti) to put toward mental illness prevention like New York does” (LeMerise 2), so this

policy may not be as impactful as first hoped. Yet the policy is still spreading by applying to and

inspiring different cultures, such as Baltimore’s similar “Don’t Die” campaign (Anzilotti).

Based on this evidence, and even with the structural barriers and other failed policies, it

seems that ThriveNYC is a policy that has won by being implemented and effectively accepted

by the people, as well as a policy that has worked by showing continuous growth in its

development of new policies that adapt as the people of New York and their culture alter. Not

only has it organized itself successfully by defining its goals for all to see, but it has also

implemented them well by using an array of mechanisms for impact. ThriveNYC, as a local

government action, works with its people, available resources, and various structures to

implement its goals, making it a highly successful policy for the time being.
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Works Cited

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